So you have EPI. Now what?
Exocrine Pancreatic Insufficiency (EPI) is a manageable condition. If you have been diagnosed with EPI, you should work with your doctor to determine a treatment plan. This may include a prescription for a pancreatic enzyme replacement therapy (PERT) option, following a nutrient-rich diet, and taking vitamin supplements. It’s also important to consult with a nutritionist to make sure all your dietary needs are being met.
For an overview of managing EPI, watch the video below.
How does pancreatic enzyme replacement therapy (PERT) work?
If you have EPI, your doctor may prescribe a PERT for you, because PERTs are the standard of care for EPI treatment. So it’s important to understand how it works. PERT is a medicine that replaces the digestive enzymes your pancreas normally produces in order to break down essential nutrients.
PERT
Lipase
(breaks down fats)
Protease
(breaks down proteins)
Amylase
(breaks down carbohydrates)
When to take a PERT
When taken as directed, with every meal and snack, a PERT helps break down the nutrients in food.
While proper diet and lifestyle can help, it’s important to continue taking a PERT with every meal & snack in order to address EPI symptoms, even if they appear to improve. Your doctor will determine the dose that is right for you.
Is EPI manageable?
Combining a PERT with a well-balanced diet and proper nutrition can help you manage the symptoms of EPI.
How is EPI diagnosed?
Where do I start with PERT?
Where do you find support?
Reference sources:
1. Alkaade S, Vareedayah AA. A primer on exocrine pancreatic insufficiency, fat malabsorption, and fatty acid abnormalities. Am J Manag Care. 2017;23(12)(suppl):S203-S209. 2. Singh VK, Haupt ME, Geller DE, Hall JA, Quintana Diez PM. Less common etiologies of exocrine pancreatic insufficiency. World J Gastroenterol. 2017;23(39):7059-7076. 3. Fieker A, Philpott J, Armand M. Enzyme replacement therapy for pancreatic insufficiency: present and future. Clin Exp Gastroenterol. 2011;4:55-73. 4. Taylor JR, Gardner TB, Waljee AK, DiMagno MJ, Schoenfeld PS. Systematic review: efficacy and safety of pancreatic enzyme supplements for exocrine pancreatic insufficiency. Aliment Pharmacol Ther. 2010;31(1):57-72. doi:10.1111/j.1365-2036.2009.04157.x 5. Pezzilli R, Andriulli A, Bassi C, et al; Exocrine Pancreatic Insufficiency collaborative Group. Exocrine pancreatic insufficiency in adults: a shared position statement of the Italian Association for the Study of the Pancreas. World J Gastroenterol. 2013;19(44):7930-7946. 6. Ferrone M, Raimondo M, Scolapio JS. Pancreatic enzyme pharmacotherapy. Pharmacotherapy. 2007;27(6):910-920. 7. Lindkvist B. Diagnosis and treatment of pancreatic exocrine insufficiency. World J Gastroenterol. 2013;19(42):7258-7266. 8. Smith RC, Smith SF, Wilson J, et al; Working Party of the Australian Pancreatic Club. Summary and recommendations from the Australasian guidelines for the management of pancreatic exocrine insufficiency. Pancreatology. 2016;16(2):164-180. 9. Pancreatic enzymes. Pancreatic Cancer Action Network website. https://www.pancan.org/facing-pancreatic-cancer/living-with-pancreatic-cancer/diet-and-nutrition/pancreatic-enzymes/. Accessed December 15, 2020. 10. Domínguez-Muñoz JE. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr Gastroenterol Rep. 2007;9(2):116-122. 11. Windsor JA. Pancreatic enzyme replacement therapy in chronic pancreatitis: a long way to go. Gut. 2017;66(8):1354-1355.